Download CogniPlus: Training cognitive functions

COGNIPLUS
www.schuhfried.com
Training
cognitive functions
For attention, memory, executive functions, spatial processing,
visuomotor skills and neglect
#03.2
Contents
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4  YOU GET MORE
4  CogniPlus? CogniPlus!
5  7 reasons to choose CogniPlus
+43 2236 42315
Address
Find it fast:
CogniPlus From A-Z
7  ALERT Attention: Alertness
14  CODING Working memory: Spatial coding
16  Dateup Working memory: Updating – spatial
11  DIVID SCHUHFRIED GmbH
Hyrtlstrasse 45
2340 Moedling
Austria
Attention: Divided
10  FOCUS Attention: Focused
18  HIBIT-R Executive functions:
Response inhibition - revised version
17  NAMES Long-term memory:
Learning of face-name associations
15  NBACK Working memory: Updating – visual
19  PLAND Executive functions:
Help Desk
Planning and action skills
20  ROTATE Spatial processing: Mental rotation
9  SELECT Attention: Selective
Queries on installation and
operation for our customers
12  SPACE Neglect/visual field training:
Mon. – Thurs.: 8 .30 a.m. – 4.30 p.m.
Fri.: 8 .30 a.m. – 1.30 p.m.
Visuospatial attention
8  VIG Attention: Vigilance
21  VISMO Visuomotor coordination
E-mail
[email protected]
Telephone
+ 43 2236 42315-60
13  VISP Working memory:
Rehearsal – visuospatial
6  THE COGNIPLUS TRAINING PROGRAMS
7  Attention
7ALERT – Attention: Alertness
8VIG – Attention: Vigilance
9SELECT – Attention: Selective
10FOCUS – Attention: Focused
11DIVID – Attention: Divided
12  Neglect/field of view training
12 SPACE – Neglect/visual field training: Visuospatial attention
13  Working memory
13VISP – Working memory: Rehearsal – visuospatial 14CODING – Working memory: Spatial coding
15NBACK – Working memory: Updating – visual
16DATEUP – Working memory: Updating – spatial
17  Long-term memory
17NAMES – Long-term memory: Learning of face-name associations
18  Executive functions
18HIBIT-R – Executive functions: Response inhibition - revised version
19PLAND – Executive functions: Planning and action skills
20  Spatial processing
20ROTATE – Spatial processing: Mental rotation
21  Visuomotor skills
21 VISMO – Visuomotor coordination
22 Languages
23 
THE VIENNA TEST SYSTEM Neuro
25 
THE VIENNA TEST SYSTEM aND COGNIPLUS:
A great team!
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TRAINING AT THE COMPUTER
User-friendly software
Input devices
A typical training session
Direct training
30 SERVICE
About this document:
SCHUHFRIED GmbH
Hyrtlstrasse 45
2340 Moedling
Austria
E-mail: [email protected]
Internet: www.schuhfried.com
Tel.: +43 2236 42315
Fax: +43 2236 46597
Media owner and editor: SCHUHFRIED GmbH
Place of publication: Moedling, Austria
Release date: 09/2014
Publisher: druck.at, Leobersdorf
Editors-in-chief: Doreen Kallweit, Johanna Egle
Graphics: Johanna Kurz, www.kurzundkallweit.at
Photos: SCHUHFRIED GmbH; fotolia (Cover: Robert Kneschke); shutterstock (Cover:
Denis Babenko; p.24 Yuri Arcurs, Konstantin Sutyagin, Alexander Raths, Lisa F. Young,
Polina Nefidova; p.23 Yuri Arcurs, rangizzz; p.29 Ilike; p.30 Yuri Arcurs; p.31 Yuri
Arcurs; p.34 Daboost ); istock (p.4 LdF; p.33 avdeev007)
Copyright © SCHUHFRIED GmbH, Moedling. All rights reserved
For the sake of readability the masculine form has been used
throughout to designate both genders.
30  Best Practice: CogniPlus in use
34  System requirements
35  Also from SCHUHFRIED: the Vienna Test System & Biofeedback 2000 x-pert
Die CogniPlus-Trainingsverfahren
You
get more
You get more
7 reasons to choose CogniPlus
1|
Developed by
prominent scientists
Many prominent scientists, including Prof. Walter
Sturm, Prof. Joachim Funke and Prof. Matthias Weisbrod, have worked with experts at SCHUHFRIED to
develop CogniPlus. Extensive experience combined
with the know-how of the best
of the best makes CogniPlus
Worth knowing
one of the most advanced
Prof. Dr. Walter Sturm has been head
cognitive training programs on
of the clinical neuropsychology dethe market today.
partment at the neurological clinic of
the medical faculty of RWTH Aachen
University since 1995. His main areas
of research are neuropsychological
assessment, treatment of attention
disorders, functional reorganisation
after attention therapy and functional
imaging of attention functions.
Firm foundations: In 1993 Prof.
Sturm and his colleagues developed the AIXTENT training
program for the treatment of
attention disorders. Efficiency
studies showed that training
must be deficit-specific if it is
to be effective. Building on this insight, SCHUHFRIED
worked with Prof. Sturm to produce a second-generation version of AIXTENT (AIXTENT II), which later became known as CogniPlus.
CogniPlus? CogniPlus!
is a product of the SCHUHFRIED company – your
specialist in computer-based psychology.
2|
is a training system for training cognitive functions.
Efficient. Multi-media. Motivating.
is scientifically based and incorporates up-to-date
psychological findings. The content of CogniPlus is closely linked to
the Vienna Test System – internationally the most widely used test
system for professional psychological assessment. This means that
diagnosis, treatment and evaluation can be efficiently linked.
is available in a wide range of languages – at no extra
cost. So that each client can train in his own language.
Read more
… about the interlinking of
CogniPlus and the Vienna
Test System.
ii page 23
Read more
… about the language versions.
You too can profit from a state-of-the-art program that covers all
areas of cognitive training!
ii page 22
Based on a function-oriented
intervention approach
Each CogniPlus training program is tailored to a specific deficit, because studies have shown that use of
over-complex training programs may actually cause
performance to deteriorate. Training programs are
only offered for cognitive functions that are scientifically proven to be trainable.
3|
Embedded in a context of
scientific theory
CogniPlus training programs are always developed in
the light of the relevant up-to-date scientific literature.
Theory-led design is a top priority. All our partners are
noted for their theoretical expertise as well as their
practical clinical experience.
4|
Realistic and
motivating design
5|
Adapts automatically to
the client's ability
Clients want to apply their improved skills as quickly
as possible in everyday life. In CogniPlus the ability
dimensions being trained are almost always embedded
in lifelike scenarios. This has been achieved through
collaboration with computer game programmers, who
have produced impressive three-dimensional scenes.
It is this appealing, modern and motivating appearance
that makes CogniPlus popular with clients.
CogniPlus is an intelligent interactive system which is
neither too easy nor too difficult for the client. It reliably
identifies the client's ability level and adapts automatically to it. One of the conditions for successful training
is thus met: the users of the program are motivated.
6|
Training at all
ability levels
The CogniPlus training programs can be used across
the entire ability range. This opens up completely new
opportunities for use alongside the traditional areas of
application such as the rehabilitation of patients with
brain damage. For example, CogniPlus can be used to
improve the driving-related skills of people convicted
of traffic offences, to improve the attention of children
with ADHD, or to improve the mental activation of
patients with MCI.
7|
Recommended by
respected institutions
The Aixtent training programs, which led to the development of the CogniPlus attention training modules, are
listed with recommendation strength A in the guidelines
of the Society for Neuropsychology (Gesellschaft für
Neuropsychologie - GNP, 2009) and the German Society for Neurology (Deutsche Gesellschaft für Neurologie – DGN, 2008).
A
Recommendation
strength
Request the demo version now without obligation!
4 . COGNIPLUS
COGNIPLUS
.5
The CogniPlus training programs
The CogniPlus training programs
Attention: Alertness
ALERT
Walter Sturm © SCHUHFRIED GmbH
Dimension
SubDimension
specific
function
Alertness
Intensity
Vigilance
Attention
Selective attention
Selectivity
Focused attention
Divided attention
Neglect/visual
field training
Visuospatial attention
Rehearsal – visuospatial
Spatial coding
Working memory
Memory
Updating – visual
Updating – spatial
Long-term memory
Executive
functions
Spatial processing
Visuomotor skills
Worth knowing
When you buy the CogniPlus administration software (or an update) you will
receive 20 hours of free training to use
with any of the CogniPlus programs.
Learning of face-name
associations
Response inhibition
CogniPlusTraining
ALERT
 read more on page 7
VIG
 read more on page 8
Select
 read more on page 9
FOCUS
 read more on page 10
Divid
 read more on page 11
Space
 read more on page 12
Visp
 read more on page 13
Coding
 read more on page 14
Nback
 read more on page 15
DATEUP
 read more on page 16
Names
 read more on page 17
HIBIT-R
 read more on page 18
Pland
Planning and
action skills
 read more on page 19
Mental rotation
Rotate
Visuomotor coordination
The ALERT training program trains the alertness dimension of attention – the ability to
temporarily increase and sustain the intensity
of attention.
 read more on page 20
VISMO
Theory
When the intensity of attention is temporarily aroused
exogenously by a warning signal, phasic alertness is involved. If the arousal occurs without a cue, the situation
involves intrinsic alertness. The aim of alertness training must be to increase intrinsic alertness, since only
in this case is arousal entirely cognitively controlled.
However, where there are deficits related to alertness it
is necessary to first improve phasic alertness and only
then to proceed to working on intrinsic alertness.
Setting and task
A motorcycle is driven along a winding road. The client’s task is to carefully observe the stretch of road in
front of him and to press the reaction key as quickly as
possible when obstacles appear. If the client reacts in
time the motorcycle slows down and the obstacle disappears so that the rider can continue on his way. If the
reaction is delayed there is an “emergency stop”; there
is a loud braking noise, the motorcycle comes to a halt
and a yellow exclamation mark appears on the screen.
the acoustic and visual warning signals are omitted.
The motorcycle then travels through a foggy night-time
landscape, in which the obstacles suddenly appear out
of the mist.
Difficulty structure
Each of the two training forms contains 18 difficulty levels. The degree of challenge is increased by shortening
the maximum permitted reaction time. At the first level
the client has 1.8 seconds in which to react to an obstacle, but at the highest level only 0.3 seconds elapse
between the sudden appearance of an obstacle and the
emergency braking.
At the first session the speed of the client’s initial reactions is assessed and he is assigned to a difficulty
level appropriate to his ability. This ensures that from
the outset the training program is optimally adapted to
the client’s skill and is never either too easy or too difficult for him.
Worth knowing
Training forms
ALERT can also be used with patients
The ALERT training program consists of two training
forms. The S1 training form trains phasic alertness,
while the S2 training form trains intrinsic alertness. In
the S1 training form the obstacles designed to externally arouse the client’s attention are preceded by acoustic and visual warning signals. In the S2 training form
with disorders of the field of vision.
The instruction pages are then displayed on one side of the screen and
the obstacles only appear on one side
(e.g. trees only fall onto the carriageway from the right).
 read more on page 21
The range of CogniPlus training programs keeps growing!
Visit www.schuhfried.com for the latest information.
Corresponding test in the
Vienna Test system
WAFA
6 . COGNIPLUS
COGNIPLUS
.7
The CogniPlus training programs
VIG
The CogniPlus training programs
Attention: Vigilance
Attention: Selective
Walter Sturm © SCHUHFRIED GmbH
The VIG training program trains the attention
dimension of vigilance – the ability to sustain
attention over a lengthy period of time under
monotonous stimulus conditions.
Theory
Long-term alertness tasks require the client’s attention
“to be focused continuously for long periods of time on
one or more sources of information, in order to detect
and respond to small changes in the information presented” (Davies et al. 1984). Vigilance represents a special variant of long-term attention. Vigilance tasks make
demands on attention over a long period of time – often
a number of hours – and the
relevant stimuli typically occur
Worth knowing
VIG can also be used with patients with at very irregular intervals and
at a very low frequency among
impaired field of vision.
a large number of irrelevant
stimuli. Vigilance training cannot be effective unless a training session lasts for more
than 30 minutes at the minimum.
Setting and task
The client is driving along a straight highway. At irregular
intervals other vehicles come towards him on the opposite
carriageway or overtake him. The client’s task is to react
by pressing a button when an overtaking vehicle suddenly
brakes in front of him. Once he has reacted the vehicle’s
brake lights go out and it accelerates away from him. If
the client fails to react within the permitted time, the brake
lights start to flash. Eventually there is a loud squealing
noise, which is designed to draw the client’s attention to
what is happening.
Corresponding test in the
SELECT
Walter Sturm © SCHUHFRIED GmbH
The SELECT training program trains selective
attention – the ability to respond quickly to
relevant stimuli and to suppress inappropriate
responses.
Difficulty structure
Theory
Difficulty structure
The VIG training program has 30 difficulty levels. A decreasing stimulus frequency makes it more and more
difficult for the client to sustain his attention: he is overtaken by other cars increasingly rarely, the surroundings
become more monotonous as darkness falls and the
number of sudden braking manoeuvres from overtaking
vehicles decreases. In addition, the intensity of the feedback on delayed and omitted reactions becomes weaker
as the difficulty level increases. The challenge therefore
changes gradually from a sustained attention task to one
requiring real vigilance.
An attention selectivity training program should help the
client to distinguish rapidly between relevant and irrelevant aspects of a task. Most selective attention tasks
require a quick decision within a set of stimuli in which
the relevant and irrelevant items are clearly defined.
There are 15 difficulty levels for each training form.
SELECT adapts to the client’s ability level in two ways.
Firstly, the number of relevant or irrelevant stimuli increases or decreases. Secondly, at each difficulty level
the maximum permitted reaction time adapts to the speed Worth knowing
of the client’s reactions. Thus SELECT can also be used with patients
for a skilled client the wagon with impaired field of vision.
gets faster after the first few
responses. This ensures that
from the outset the training program is optimally adapted
to the client’s skill and is never either too easy or too difficult for him.
At each difficulty level the maximum permitted reaction
time adapts to the speed of the client’s reactions. Taking the client’s first valid reactions as a starting point, an
individual reaction time limit is determined and used as
a basis for measuring all further reactions made in the
course of the training program. This ensures that from
the outset the training program is optimally adapted to
the client’s skill and is never either too easy or too difficult for him.
Setting and task
The client travels through a tunnel in a mine car.
Relevant and irrelevant stimuli (optical, acoustic or
crossmodal) suddenly emerge from the darkness. The
client’s task is to respond only to relevant stimuli. If he
responds late to a relevant stimulus or fails to respond
at all, negative feedback is given in the form of a crash
of thunder and a flash of lightning. If the client responds
in error to an irrelevant stimulus, the figure or the sound
source is illuminated in red.
Training forms
The SELECT training program consists of three training
forms.
The S1 training form trains selective attention in the
visual modality (figures appear in the tunnel).
S2 is the acoustic training form, in which the client’s
task is to respond to relevant sounds.
In the S3 training form the client is instructed to respond to specific stimulus combinations (figures that
make particular noises).
Corresponding test in the
Vienna Test system
Vienna Test system
WAFV
WAFS
8 . COGNIPLUS
COGNIPLUS
.9
The CogniPlus training programs
FOCUS
The CogniPlus training programs
Attention: Focused
Attention: Divided
Walter Sturm © SCHUHFRIED GmbH
The FOCUS training program trains focused
attention – the ability to respond only to
relevant stimuli among a high density of
distracting stimuli.
Theory
Focused attention describes the ability to isolate a segment of reality in order to be able to analyse it more
closely. It is particularly important to be able to maintain this focus in the face of distractions and to suppress the interference caused by the simultaneous and
automatic processing of information.
Setting and task
A boat travels through a lush African landscape. The
client is confronted with a wide range of different stimuli: screeching birds, flying dragonflies, a ruin on the
banks of a river, a waterfall etc. His task is to respond
to pre-defined relevant stimuli without letting himself be
distracted by the large number of other stimuli.
Corresponding test in the
DIVID
Walter Sturm © SCHUHFRIED GmbH
The DIVID training program trains divided
attention – the ability to perform different
tasks simultaneously.
Training forms
Theory
The FOCUS training program consists of two training
forms, each of which has ten difficulty levels:
T he S1 training form requires the client to recognise
visual stimuli against a background of distracting
stimuli which may be acoustic, visual, or a combination of the two.
I n the S2 training form the task is to detect acoustic
stimuli in the face of other stimuli which may likewise
be acoustic, visual, or a combination of both.
The ability to divide one’s attention depends on the processing resources available and on the nature of the
combined tasks. The more similar the tasks, the greater the interference that arises between them (Wickens,
1984). In everyday life the ability to split one’s attention
is relevant to many skills – for example, driving a car,
which normally requires the simultaneous monitoring of
a number of different information streams.
Difficulty structure
In this training program the client takes on the role of a
security official at an airport. He has to simultaneously observe both a range of scenes on several control
monitors (sliding doors at the entrance, ticket counter,
luggage conveyor) and announcements made over the
loudspeaker system. His task is to deal with problems
that occur by pressing the response key. If the client
fails to react promptly to a problem or a relevant announcement, the picture is frozen on all channels and
the channel on which the problem occurred is highlighted. The events displayed do not continue until the reaction button is pressed.
The difficulty structure of the FOCUS training program
is designed to adapt as far as possible to the amount
that the client can take in. Thus a client of weak ability will be presented with a low-stimulus environment,
while a client of strong ability will be confronted with a
large number of distractor stimuli. The number of distractor stimuli presented is carefully graded and the
time allowed for identification of a stimulus is adapted
to the client’s skill.
Setting and task
Difficulty structure
DIVID has 15 difficulty levels. The difficulty levels vary
in terms of the number of channels that the client has to
monitor, the frequency of breakdowns, the minimum interval between two breakdowns and the maximum time
allowed for noticing a breakdown.
Corresponding test in the
Vienna Test system
Vienna Test system
WAFF
WAFG
10 . COGNIPLUS
COGNIPLUS
. 11
The CogniPlus training programs
SPACE
The CogniPlus training programs
Neglect/visual field training: Visuospatial attention
Working memory: Rehearsal – visuospatial
Walter Sturm © SCHUHFRIED GmbH
The SPACE training program was created for
patients with hemineglect but it can also be
used successfully with patients who have an
impairment of the visual field. It improves the
visuospatial directing of attention and is intended to train the specific ability to direct attention to stimuli on the contralesional side of
the field of vision.
Theory
observation. The task is to take a “photo” by pressing
the reaction key as soon the viewfinder stops and has
“captured” an object. In each scene there is a fixation
point in the center towards which the client should direct
the position of his head and the direction of his gaze and
where he can find the viewfinder if he has lost sight of it.
In everyday life our attention may be focused on a different source from our perceptive organs. Peripheral
stimuli lying outside our central field of vision can attract
the focus of attention to themselves. They then bring
about a change in the direction of gaze or a turning of
the head towards an object or event (visuospatial attention). Peripheral cues tend to bring about an automatic
(exogenous) spatial shift of attention, while central cues
(e.g. an arrow in the fixation point pointing to the left or
right) are more likely to produce a cognitively controlled (endogenous) shift of attention, since a particular expectation is generated. Both peripheral and central cues
cause a covert shift of attention to the right or left and
thus make it easier to detect stimuli in the half of the
visual field in which the cues occur or to which they point
(valid condition). However, if the cue is in the wrong half
or points in the wrong direction (invalid condition), the
speed of reaction to the target stimulus is slowed, since
attention must first be shifted from the “wrong” focus to
the correct spatial position.
Difficulty structure
Setting and task
The instructions for the SPACE training program are
displayed on only one side of the screen and are therefore easily read by patients with neglect or visual field
impairment.
The client assumes the role of a photographer. His task
is to observe various scenes such as a market place, airport, office, children’s playground etc. The camera viewfinder moves towards a particular point in the area under
Corresponding test in the
VISP
Dieter Schellig, Uwe Schuri, Walter Sturm © SCHUHFRIED GmbH
There are ten different difficulty levels, each of which
displays a different scene of interest on the screen. The
level of difficulty is increased by varying the way in which
the viewfinder moves (continuous movement, jumping Worth knowing
movement, with and without We recommend the use of monitors
a return to the center) and with a screen diagonal of at least 19"
the complexity of the scene. so that the area of the visual field
In addition, at the lower lev- being trained is as large as possible.
els of difficulty the task is
made easier by an acoustic
and visual cue (sound and arrow in the middle of the
viewfinder) which indicates the direction of the next
movement. At the higher levels of difficulty only irregular
cues are given, and the cues may give no indication of
direction or even be completely wrong – for example, the
arrow in the viewfinder may point to the upper right while
the viewfinder jumps to the lower left.
VISP is a training program for improving active
rehearsal in spatial working memory.
Theory
Difficulty structure
Rehearsal processes can improve short-term and longterm memory. However, rehearsal is not a form of simple
storage but a controlled and attention-based series of
retrievals and re-encodings of material, the aim being
to maintain this material from perceptual processing or
long-term memory in the focus of attention.
Spatial attention is the central process in spatial rehearsal – just as subvocal articulation is the key function
for verbal rehearsal. For example, we let our gaze travel
repeatedly from one location to another, thereby allowing our attention to shift sequentially between various
spatial positions and protecting this spatial information
against forgetting.
The VISP training program has 18 difficulty levels. The
demands on visuospatial working memory are varied in
a number of ways. At some levels the ships move, while
at others they remain motionless at anchor. Across the
levels there is an increase in the number of ships that
the client must actively rehearse and reproduce. The
number of ships on the screen and the length of time for
which they are highlighted also vary.
Setting and task
In VISP the client has a bird's-eye view of a number of
ships on the ocean. Some of the ships are indicated in
turn (e.g. they are illuminated or disappear). This is the
memorizing phase. In the rehearsal phase that follows,
the client is encouraged in various ways to practice rehearsal. He must subsequently reproduce the sequence
in which the ships were indicated (recall phase).
Through various forms of guidance the client is trained to
improve his remembering of the ships’ positions by practicing sequential rehearsal during the rehearsal phase.
The rehearsal aids are gradually reduced as the client
progresses through the levels. At the outset the ships
are highlighted again during the rehearsal phase in the
same order as during the memorizing phase. Later the
ships are shown in the rehearsal phase without highlighting, so that the client must now shift his attention
between the positions unaided. At the higher difficulty
levels the ships eventually disappear and the client must
click with the mouse to indicate where the highlighted
ships were previously seen.
Note
Corresponding test in the
Vienna Test system
Vienna Test system
WAFR
CORSI
12 . COGNIPLUS
COGNIPLUS
. 13
The CogniPlus training programs
CODING
The CogniPlus training programs
Working memory: Spatial coding
Working memory: Updating – visual
Dieter Schellig, Uwe Schuri, Walter Sturm © SCHUHFRIED GmbH
Theory
Both monitoring and coding are base mechanisms of
working memory. They are used for (metacognitive)
control and coordination of cognitive processes and
form the basis for more complex cognitive activities.
Monitoring in working memory involves the controlled
supervision of storage processes and stored representations. Storage in spatial working memory requires the
coding of incoming information according to its spatial
features: the location at which the stimuli were perceived and/or their spatial arrangement is stored. Spatial coding links the individual items to representations
(binding) and gives them a structure. There is no “pure”
representation of a visually perceived stimulus; each
stimulus also has a spatial “code”.
For example, the information that a driver obtains by
looking in his rear-view mirror is incorporated into the
stored image of the driving environment. More complex
examples include following assembly instructions or
wiring diagrams, creating mind maps, or working with
multiple open windows on a computer.
Setting and task
The client observes vehicles driving onto a bridge (memorizing phase). While driving over the bridge the vehicles disappear from the client's view (rehearsal phase).
When they reappear at the end of the bridge, one of the
vehicles may have changed its position in the spatial ar-
Corresponding test in the
NBACK
Markus Sommer, Rudolf Debelak, Christine Heidinger © SCHUHFRIED GmbH
CODING is a program for training monitoring
processes and spatial coding in visuospatial
working memory.
The NBACK training program trains the monitoring function of working memory – the ability to
retain information and continuously update it.
rangement. This vehicle must be identified (recall phase)
– this involves comparing the new arrangement of the
vehicles as they leave the bridge with the stored layout
of their previous arrangement and scanning the new arrangement for differences.
Theory
Difficulty structure
CODING has 21 difficulty levels. At the different difficulty levels different storage and retrieval strategies
are required, ranging from the identification of errors to
reconstruction of the original sequence and the correction of errors. The demands on monitoring processes
increase throughout the program.
The lower difficulty levels train the monitoring skills required to identify errors: the client must decide whether
or not the arrangement of the vehicles shows changes/
errors (yes/no answers). Later the client must click on
the vehicle that has changed its position within the spatial arrangement. Finally at the highest level the difficulty is increased by the disappearance at the recall
stage of the spatial structures between the vehicles;
the scene must be reconstructed from memory. At this
level the client must dissolve his binding of the entire
spatial structure.
The program is adaptive: because the client is constantly working at the limit of his individual ability, there
is little scope for automated processing – controlled
monitoring must therefore be continuously applied.
Working memory is of key importance in dealing with
the demands of everyday life, especially when information that has been briefly presented must be retained
and cognitively processed, or when a task needs to be
performed or a goal achieved. Many diseases such as
Alzheimer’s disease, Huntington's chorea, Parkinson's
disease or attention deficit hyperactivity disorder are associated with impairments of working memory and consequent difficulties in coping with everyday tasks.
Recent scientific findings indicate that the capacity of
working memory can be improved through regular training. As the work of various researchers has shown, the
effect of such training is enhanced if the training tasks
adapt to the client’s ability level. This is the case in
NBACK. The training material consists of n-back tasks
which require the client to react to stimuli that recur at
a particular interval. These tasks place demands on the
client’s ability to retain task-related information and continuously update it in his mind.
Setting and task
In the NBACK training program the client sees a representation of a digital picture frame on his screen. A succession of photographs appears in the frame; the photos have different subject matter (animals, landscapes,
colors etc.). The client’s task is to decide whether the
current photograph matches the one that was shown
one, two or three places back (the number of places
varies with the level). If it matches, he should press the
green button. If it does not match, the red button must
be pressed.
The client receives feedback on his performance at
regular intervals (approx. every 5 minutes). The aim of
this feedback is to maintain the client’s motivation at an
optimal level.
Difficulty structure
NBACK has 15 difficulty levels and adapts to the client’s
ability in four ways.
1.The difficulty is varied by changing the number of
stimuli that the client must remember. At the lower levels
the current stimulus needs only to be compared with the
immediately preceding one. At the highest levels the current stimulus must be compared with the one that was
displayed three places back.
2.The semantic similarity of the pictures represents an
additional difficulty parameter. At higher levels the pictures become more similar.
3.The picture content becomes more abstract and hence
more difficult to verbalise.
4.The picture presentation time becomes shorter as the
difficulty increases.
Corresponding test in the
Vienna Test system
Vienna Test system
CORSI
NBN 14 . COGNIPLUS
COGNIPLUS
. 15
The CogniPlus training programs
DATEUP
The CogniPlus training programs
Working memory: Updating - spatial
Long-term memory: Learning of face-name associations
Dieter Schellig, Uwe Schuri, Walter Sturm © SCHUHFRIED GmbH
The DATEUP training program trains the executive updating function of spatial working memory. Updating is the ability to renew
memory contents in a controlled and goaldirected manner.
The NAMES training program enables the client to practice effective strategies for learning people's names and associating them with
faces.
Theory
Setting and task
Theory
Updating information is a fundamental cognitive process. New stimuli and information from perception or
long-term memory bombard us constantly and replace
older versions – continuous updating is required. For example, driving in a city involves a rapid and continuous
process in which observed situations are briefly stored,
compared with newly perceived ones and immediately
replaced – for instance if a number of vehicles are approaching an unsigned junction and it is necessary to
decide who has priority. At the same time, information
from long-term memory is activated in order to identify what has been perceived and process it in a goaldirected manner; for example, on European roads this
will involve recalling the rule which states that drivers
must give way to traffic from the right. In the scientific
literature updating is regarded as one of the basal executive control mechanisms of working memory. These
mechanisms are used to control and coordinate cognitive processes and form the basis for more complex
cognitive processing. The executive functions of working memory can be improved through repetitive training
(Olesen et al., 2004; Erickson et al., 2007; Jaeggi et al.,
2008; Dahlin et al., 2008). The DATEUP program trains
the updating function by means of tasks of three types
that are widely used and well-confirmed in the literature:
running tasks, keep-track tasks and n-back tasks. The
aim of training is to achieve more flexible and more automated updating of material in spatial working memory
and to improve complex cognitive functions.
The client watches butterflies in a natural setting as they
fly over flower meadows and sandy ground. From time to
time one butterfly lands and another starts its flight etc.
until eventually, at irregular intervals, the client is asked
a question. Depending on the type of task, the client
must now highlight one or more butterflies – for example
the last but one butterfly, the last three butterflies or the
last of each of three different butterfly types.
According to current psychological models of cognition,
people's names have fewer structural bindings than other
identity-specific semantic details (such as occupation or
nationality) and names of objects. Because of their limited
binding, the learning and later recall of people's names
is a particularly demanding cognitive task. However, performance in learning face/name pairs can be improved
by applying particular processing strategies – such as
conscious linking with information already in memory and
use of mental imagery.
Corresponding tests in the
NAMES
Uwe Schuri, Dieter Schellig, Walter Sturm © SCHUHFRIED GmbH
Difficulty structure
The DATEUP training program has 25 difficulty levels.
The demands on working memory are heightened mainly
by increasing the number of stimuli (butterflies) that the
client must retain and update. The three types of task
(n-back, running, keep-track) occur one after the other across the different levels; at the highest levels they
are combined to form new task variants. As the level increases both the number of butterflies on the screen and
their speed also increase. In addition, the timing of the
questions becomes increasingly unpredictable as the
client progresses through the levels.
Setting and task
Difficulty structure
In NAMES the client is instructed to remember the names
of individuals. The names must then be recalled when
pictures of the individuals are displayed. In the course of
training the client is taught strategies to assist learning
and recall. The difficulty of the tasks is varied systematically in the course of the program. At the most advanced
difficulty levels the individuals are introduced to the client
by a speaker, as at a party. This is intended to simulate
a real-life situation in which a number of names must be
remembered in a short period of time and thus facilitate
transfer to everyday life.
In the NAMES training program difficulty is varied by
changing the number of people in a set to be learned,
the extent to which the names conjure up meanings or
images, the appearance of the individuals and the way in
which the task is presented. In addition, at the lower levels
there is an option to view hints on memorizing strategies
and to enter tips that the individual has devised.
Corresponding test in the
Vienna Test system
Vienna Test system
NBN / CORSI
FNA
16 . COGNIPLUS
COGNIPLUS
. 17
The CogniPlus training programs
HIBIT-R
The CogniPlus training programs
Executive functions: Response inhibition - revised version
Executive functions: Planning and action skills
Matthias Weisbrod, Stefan Kaiser, Ute Pfüller, Daniela Roesch-Ely, Steffen Aschenbrenner © SCHUHFRIED GmbH
The HIBIT-R training program trains response
inhibition – the ability to suppress unwanted
reactions.
In the PLAND training program action and
planning skills are trained through the presentation of realistic planning tasks.
Theory
Setting and task
Theory
In everyday life the ability to suppress unwanted reactions
is an important component of the ability to act flexibly
and appropriately. If environmental conditions change,
practised reaction patterns are often dysfunctional and
must be suppressed, so that new behaviour appropriate
to the situation is possible. Deficits of response inhibition
are reported
in diseases characterised by impairment of impulse
control (e.g. ADHD, borderline personality disorder,
dependency disorders)
in diseases characterised by rigid and inflexible behaviour (schizophrenia, compulsive disorders)
in various neurological diseases (Parkinson's disease,
dementia of the Alzheimer's type).
In the HIBIT-R training program the client assumes the
role of a post-office employee who must sort letters
and packages as quickly and accurately as possible by
pressing a button. He must look out for specific features
(e.g. the presence of a stamp) that indicate when he
must react and when he must not react. Four different
scenarios (Go-Nogo, Stop-Signal Task, Cued Go-Nogo,
Behavioral Shift) make different demands on the client's
ability to suppress a reaction. In HIBIT-R the client is
free to choose between different tasks and is therefore
instrumental in making the program motivating.
Meaningful and independent action in everyday life becomes possible only when behaviour is planned and
organised over a relatively long period and competition
between tasks is dealt with by setting priorities. Planning ability can be impaired by brain damage of any
etiology and origin, especially where there is damage
to frontal structures or diffuse cerebral damage. Executive functions can also be affected by a range of psychiatric illnesses, including schizophrenia and depression. PLAND is a training system based on everyday
activities which enables clients to practise creating and
implementing schedules of varying complexity. It gives
the therapist the opportunity to work interactively with
the patient to devise various strategies for improving
cognitive functions and self-control. The aim is to improve planning and action skills in everyday situations.
Corresponding test in the
Difficulty structure
The difficulty levels of HIBIT-R vary systematically in the
demands they make on response inhibition. The inhibition
of responses is made more difficult across the difficulty
levels by a reduction in the number of no-go stimuli,
shorter presentation time of the letters and packages
and an increasing number of discriminators (several
stamps, additional inscriptions on a package).
PLAND
Daniel V. Holt, Joachim Funke © SCHUHFRIED GmbH
plan on which various buildings and the client's current
position are marked. In accordance with the planning
task the client must devise a strategy for deciding the
order in which the different components of the task will
be tackled and hence the order in which the buildings
will be visited.
Training forms
The PLAND training program consists of three training forms (S1, S2 and S3) in which the task varies in
accordance with three types of requirement: observing
priorities, minimising journey time and maximising the
number of tasks completed.
Difficulty structure
Setting and task
The S1 training form has 19 difficulty levels, the S2
form has 16 and the S3 form 28. In all training forms the
number of things that need to be done increases as the
difficulty level rises.
In the PLAND (Plan a Day) training program, the client
is given the task of deciding on the best order in which
to carry out the day's activities. The starting point is a
list of things that need to be done and a virtual street
Depending on the training form, other difficulty parameters may be added as the difficulty level increases (e.g.
increase in overlapping appointments).
Corresponding test in the
Vienna Test system
Vienna Test system
INHIB
PAD 18 . COGNIPLUS
| in implementation |
COGNIPLUS
. 19
The CogniPlus training programs
NEW
ROTATE
The CogniPlus training programs
Spatial processing: Mental rotation
Visuomotor coordination
Markus Sommer, Christine Heidinger © SCHUHFRIED GmbH
ROTATE trains the ability to form a three-dimensional mental image of an object depicted
in two dimensions and to manipulate the image by means of a change of perspective or
rotation (mental rotation).
The VISMO training program trains visuomotor coordination - the ability to coordinate
hand and arm movements in response to visual stimuli.
Theory
Setting and task
Theory
Current theoretical models of this ability area assume
that the process of solving mental rotation problems
involves four stages (see Just & Carpenter 1985, Arendasy & Sommer 2010):
In the ROTATE training program the client is shown 3D
objects that he must compare with reference pictures.
Two types of task are presented alternately.
1. In the change of perspective tasks the client sees the
object on the right-hand side of the screen surrounded
by cameras. He must work out which camera was used
to take the picture shown on the left of the screen.
2. The rotation tasks are similar. In this case the screen
shows symbolic axes of rotation (“rotation rods”), which
can be used to rotate the object in space. The client
must work out which axis needs to be used to rotate the
object in order to create the reference picture.
 Search stage:
the search for corresponding object parts
 Encoding stage:
constructing a mental image of the object to be rotated
 Transformation stage:
transformation by means of rotation or change of perspective
 Confirmation stage:
comparison of actual results with intended outcome
Studies show that this ability can be improved through
training and practice. In general the best results are
achieved by using training methods in which different
spatial strategies are permitted and practised (for a summary: Handet al., 2007).
Difficulty structure
Difficulty is varied across the various levels mainly by
changing the following task characteristics:
 the
 the
 the
 the
figural complexity of the objects
direction and angle of rotation
object’s positional complexity
complexity of the coordinate system implied by
the cameras or rotation rods.
The training program uses objects of various different
types (e.g. cartoons, buildings). The aim of using a wide
range of practice material is to improve the client’s motivation to train and to ensure that the cognitive skill that
is developed can be generalized effectively.
Corresponding test in the
VISMO
Rudolf Debelak, Christine Heidinger © SCHUHFRIED GmbH
Visuomotor coordination skills play an important part in
many everyday situations such as driving a car, using
household equipment or picking up objects.
Coordinating motor movements with visual stimuli requires a number of different abilities. First, it is necessary
to identify what movements are necessary to achieve a
particular goal. This involves creating internal models of
the movement. After this the relevant movement must be
planned and prepared, and finally the movement is executed. While the movement is being performed, the individual must use visual feedback to monitor whether the
desired goal is being achieved. If necessary the movement must be changed, or a new movement may need
to be initiated. At the same time, all external influences
on the movement – such as gravity – must be taken into
account.
VISMO trains clients’ visWorth Knowing
uomotor coordination by
means of tracking tasks.
Requires the Universal response
panel.
These involve using a
joystick to keep a circle
ii read more on page 26
positioned over a target
object on the screen. The target object moves across the
screen along a path that varies in its degree of complexity. A number of studies have shown that regular training
with tasks of this type improves visuomotor performance
in patients with motor disabilities. There is also evidence
that these tasks can improve visuomotor ability even in
people without motor disabilities.
Setting and task
In the VISMO training program the client is instructed
to observe the sky through a telescope. His task is to
keep a particular object – a satellite, planet or spaceship – within the telescope’s finder (a green circle on the
screen). Since the object is moving across the sky as it
is being watched, the client must actively track it with the
finder. The aim is not to lose the object from the finder.
The longer the finder remains on the object, the more
points the client accumulates.
Difficulty structure
The VISMO training program has 22 difficulty levels.
Training adapts to the client’s performance level in four
ways. As the difficulty level increases the path along
which the target object travels becomes invisible and
increasingly difficult to follow, the speed of the target object increases and the number of distracting objects in
the scene also increases.
Corresponding test in the
Vienna Test system
Vienna Test system
3D
2HAND
20 . COGNIPLUS
COGNIPLUS
. 21
Languages
The Vienna Test System NEURO
Neuropsychological Assessment
using the Vienna Test System NEURO
CogniPlus speaks many languages
Turkish
Dutch
German
Polish
French Italian
Russian
Chinese
English Slovak
Spanish
Arabic Hungerian
Czech
Portuguese
To enable clients to train in their own language, CogniPlus is currently available in 16 languages.
Advantages of the
Vienna Test System
NEURO
ALERT
CODING
DATEUP
DIVID
FOCUS
HIBIT-R
Names
NBACK
PLAND
ROTATE
SELECT
SPACE
VIG
VISMO
Turkish
Spanish
Slovak
Precise assessment
Russian
Portuguese Polish
Italian
Hungarian
German
French
English
Dutch
Czech
Chinese traditional Chinese simplified Arabic
The CogniPlus training programs are continually being translated
into additional languages. Visit www.schuhfried.com for up-todate information.
Basic software
The Vienna Test System (VTS) is the worldwide standard for computer-based psychological assessment. A special version has
been developed for the assessment of neuropsychological and clinical issues, known
as the Vienna Test System NEURO.
Computer-based neuropsychological tests guarantee the reliability of the assessment process through
standardized instructions, practice phases and errorfree scoring.
Administration of the tests on a computer enables patients’ time-critical responses to be measured with a
high level of precision.
Determining the type and location of a brain injury by
means of imaging techniques and apparative tests
provides initial indications of possible function impairments. Neuropsychological tests enable these function impairments to be assessed both qualitatively
and quantitatively; the test results provide information
about the extent and nature of a deficit.
Parallel versions
The Vienna Test System NEURO contains many
parallel versions of tests that help to avoid practice,
memory and learning effects when tests are administered for follow-up purposes.
Extensive norms
Extensive norm samples are available in the Vienna
Test System NEURO. It is possible to select comparative samples based on gender, education or age as
well as the total sample. For many tests the comparative group includes people aged over 85. The norms of
all tests are revised at least every eight years.
Fast assessment
Standardized computerized instructions and practice
phases save time, as does error-free computerized
scoring.
The Word reports with boilerplate texts included in
the Vienna Test System NEURO make writing reports easy.
The user-friendly administration software makes data
management efficient and straightforward.
VISP
22 . COGNIPLUS
COGNIPLUS
. 23
The Vienna Test System NEURO
The Vienna Test System NEURO
CogniPlus and the Vienna Test System:
A great team!
1|Test
Wide range
The Vienna Test Sysetm NEURO can be used to assess all relevant neuropsychological functions and partial functions (find a summary at www.schuhfried.com).
Over 120 tests are available. In addition, there are two
test sets compiled by experts which are tailored to a
specific disorder and cover the most important dimensions relevant to the disorder.
2|Train
Vienna Test system
Psychological assessment
cogniplus
Cognitive training
The Test Sets
COGBAT
DRIVESC
3|
Test the success
of training
Specific
funCtion
Vienna
Test system
Cogniplus
Alertness
WAFA
ALERT
Vigilance
WAFV
VIG
Selective
WAFS
Select
Focused
WAFF
FOCUS
Divided
WAFG
DIVID
Visuospatial
attention
WAFR
Space
Rehearsal –
visuospatial
CORSI
Visp
Spatial coding
CORSI
Coding
Updating – visual
NBN
Nback
Updating – spatial
CORSI
Dateup
Learning of facename associations
FNA
Names
Response inhibition
INHIB
HIBIT-R
Planning and
action skills
PAD*
Pland
Spatial processing
Mental rotation
3D
Rotate
Visuomotor skills
Visuomotor
coordination
2HAND
VISMO
Dimension
Attention
Neglect/visual
field training
Memory
COGBAT Cognitive Basic Assessment
DRIVESC Fitness to Drive Screening
The COGBAT test set is used to clarify the cognitive
status of patients suffering from neurological and/
or mental disorders. Cognitive status needs to be
assessed as comprehensively (broadly) as possible,
but also as quickly as possible. Carefully selected
methods are used to assess subdimensions from
the fields of attention, memory, executive functions
and information processing speed. COGBAT has
been normed across all tests, and thus as an overall
package, and validated on different patient groups.
Straightforward scoring provides a rapid overview of
impaired and unimpaired dimensions.
The test set DRIVESC assesses the three key determinants of driving ability: stress tolerance, reaction time and skill in obtaining an overview. It is
an efficient tool for screening the fitness to drive
of individuals affected by neurological and/or mental disorders. The validity of the DRIVESC test set
has been demonstrated repeatedly in multi-center
studies involving healthy drivers and patients with
brain damage.
Executive
functions
*| in implementation |
24 . COGNIPLUS
The tests of the Vienna Test System
and the training procedures of CogniPlus are coordinated. The training
programs are based on the same theoretical models as the tests to which
they correspond; this provides an efficient and theoretically sound link between assessment, training and the
subsequent analysis of effectiveness.
The corresponding tests and training
programs are based on the same theoretically clearly defined constructs
but do not involve the same tasks.
This enables a reliable distinction to
be made between the material-specific learning effect and the desired
training effect.
The summary shows which CogniPlus
training programs are specifically tailored to the deficits tested by the Vienna Test System.
“Careful assessment is a prerequisite
when treating attention disorders, since
it has been shown in several therapy
studies that therapy must be tailored
to a specific deficit. Particularly in the
case of disorders of elementary attention functions (alertness, vigilance),
the use of over-complex training programs may result in a deterioration in
performance. Computerized therapy
programs that train specific attention
functions in realistic everyday situations have proved useful.“
(Guidelines of the German Society for Neuropsychological Assessment and Therapy)
COGNIPLUS
. 25
Training at the computer
Training at the computer
A typical training session
User-friendly software
The response panels can also be
used as input devices for the Vienna
Test System.
On the “Client data” index card you can enter the
client’s details.
The “Training” index card lists all the available training programs. You can select the desired program and
specify its duration. A session can consist of several
training programs presented one after the other, in the
order specified by you in the training sequence list.
Basic response panel:
NE W
 2 colour keys
 10 number keys
 USB connection
The Standard and Universal Vienna Test System response panels can also be used with the CogniPlus
training programs.
Standard response panel:
 7 colour keys
 10 number keys
 1 sensor key
 Connection for foot-operated keys
 USB connection
Universal response panel:
 2 analogue joysticks
 2 twist knobs
 7 colour keys
 10 number keys
 1 sensor key
 Connection for foot-operated keys
 USB connection
The “Results” and “Logbook” index cards provide
training results and session data. In the “Logbook”
the system automatically records the details of each
session. You can also add comments here. You thus
have a compact but complete digital client file.
If your client is able to work alone, after selecting the
training programs you can specify whether he is to
move on directly from one program to the next, thus
working his way independently through the session,
or whether you will start the next program for him.
This means that your presence during the session is
Worth knowing
not essential, unless the
Save even more time with the Direct
client needs special care
Training function!
(e.g. children or severely
ii page 29
disabled patients).
Index card 'logbook'
Worth knowing
2. Instruction phase
Each training program starts with an instruction
phase. Simply formulated instructions inform the client of what he has to do. He can spend as much time
reading them as he wishes; this prevents stress.
To make things easier for the client, all CogniPlus
programs are designed along the same lines. In addition, they make use of everyday knowledge; for example, based on traffic-light usage the start button
is always green. Guided by
Worth knowing
the careful use of size and
Because they can be presented on
color on the screen, the
one side of the screen only, the Cogniclient absorbs information
Plus training programs ALERT, VIG
selectively in accordance
and SELECT are also suitable for
with the importance of the
patients with hemineglect or hemivarious elements.
Instruction phase
Input devices
The CogniPlus training programs can be worked with
a normal computer keyboard or with SCHUHFRIED’s
Basic response panel. The mouse is needed for some
training programs, while VISMO requires the Universal
response panel.
The response panels are particularly suitable for individuals with restricted hand movement. We shall be
happy to advise you!
Starting CogniPlus takes you directly to the convenient
and detailed menu. As soon as you have registered
a client, CogniPlus opens a client file with the four
index cards, “Client data”, “Training”, “Results” and
“Logbook”.
Index card 'training'
1. Set up the training program
The CogniPlus menu is clear, user-friendly and simple
and intuitive to use. You don't need to be Bill Gates to
find your way around. That's a promise!
anopsia. The text then appears on
either the left or the right half of the
screen, depending on the region of
the neglect.
26 . COGNIPLUS
COGNIPLUS
. 27
Training at the computer
Training at the computer
3. Practice phase
The instruction phase is always followed by a practice phase. If the client’s responses indicate that he
has not yet understood the task, the system will automatically repeat the instructions. The training phase
does not start until the client has successfully completed the practice phase.
Direct training
Practice phase
A typical training session
Direct training
The new Direct Training function enables training to
be administered fully automatically without a supervisor. It is used mainly in CogniPlus networks that have
access to a central database. However, Direct Training can also be used on local CogniPlus systems.
This is how it works: You first assign each client a personal ID and set up a training session. You start Direct
Training by selecting “Direct Training” in the “System”
menu. Alternatively, Direct Training can be started
from an icon on the desktop or from the Start menu.
Training phase
4. Training phase
You can use the CogniPlus programs to carry out
training at any level of difficulty across the ability
range. If a new client commences training, CogniPlus quickly and automatically identifies his ability
level and classifies him accordingly. If the client has
already completed one or more training sessions, the
new session begins where the last one finished.
NEW
So that clients are neither under- nor over-challenged, all the training programs have been designed
to be adaptive; that is, they adapt themselves continuously to the client’s ability level.
Via his own screen the client will now be instructed
to enter his personal ID and then to confirm that his
personal details are accurate. He then accesses the
training session and training proceeds in the same
way as training started manually by the supervisor.
Worth knowing
You can also use a barcode reader to
input the client ID.
1.) For the client: Each training session concludes
with an easily read chart of performance in recent
sessions
2.) For the test supervisor: At the end of the session
detailed results of the individual programs used during that session are available. These results include
mean reaction times and the number of correct, delayed, incorrect and omitted responses at each level
of difficulty. In addition a chart records each response
made during the session in terms of difficulty level,
reaction time and scoring (correct, delayed, etc.). It
is also possible to compare performance in the most
recent session with that in the preceding sessions.
28 . COGNIPLUS
Supervisor evaluation
CogniPlus provides two types of evaluation of results:
Client evaluation
5. Evaluation of results
COGNIPLUS
. 29
Service
Service
Best practice
CogniPlus in use
Clinica Hildebrand, Centro di riabilitazione
Brissago (Switzerland)
Application: rehabilitation of cognitive functions of
adults and older people
Marco Di Gangi
Psychologist, neuropsychologist FSP
Kolpinghaus “Gemeinsam Leben” (Vienna)
Application: Geriatrics
Thomas Pletschko
Clinical and health psychologist, sociologist, Kolpinghaus für betreutes Wohnen GmbH
“In the housing complex run by Kolpinghaus für betreutes Wohnen GmbH in Vienna different generations
live side by side; the majority of residents are older
people in need of care. CogniPlus has been used since
autumn 2006. The aim of cognitive training with CogniPlus is to train functions affected by dementia-related
deterioration and to stimulate mental activity in individuals affected by symptoms of depression in old age.
Before training commences a detailed assessment is
carried out using appropriate psychological assessment tests, such as the WAF tests from the Vienna
Test System. The training sessions themselves are
conducted once a week and last for approximately
45 minutes. After twelve training sessions the progress
made is evaluated, once again by using psychological
assessment tests.
The value of CogniPlus in our residential home can be
seen in two areas. Firstly, it is very useful for the type
of dementia-related deterioration for which cognitive
training has been shown to be effective – that is, in
cases of mild cognitive impairment (which is often a
precursor of dementia) and mild dementia. Secondly, it
also has a positive effect in individuals with depressive
symptoms, with the result that these residents then report more mental activity in their everyday lives.”
30 . COGNIPLUS
“The hospital Hildebrand, from December 2007, has the
software CogniPlus with the aim to use it in the field of
rehabilitation of cognitive functions of adults and older
people who have had cerebral lesions (e.g. craniocerebral trauma, ictus, brain cancer, anorexia). The different programs of CogniPlus allow to train the capacities
of phasic and intrinsic alertness (a reaction to simple
visual or auditory stimuli with or without cue) [ALERT],
of Selective Attention (the ability to quickly and in an
appropriate way react to relevant stimuli and the consequent ability to inhibit the reactions to irrelevant stimuli)
[SELECT], of Visual-Spatial Attention (the ability to orientate attention in space to detect stimuli which are in
the visual field) [SPACE], of Divided Attention (ability to
keep ones attention to different stimuli at the same time)
[DIVID] of Vigilance (ability to maintain an adequate
concentration for long periods of time in condition of
routine) [VIG]. There are furthermore other programs,
which we still do not have, for the stimulation of the Work
Memory [NBACK], of the Focal Attention [FOCUS] and
of the Visual-Motor Coordination [VISMO].
The usefulness of such software in the clinical practice
of rehabilitation is that due to cerebral lesions, due to
different causes, the cognitive problems which have
been more frequently corroborated are in the sphere
of memory, of attention and of operational functions.
Our experience demonstrates that patients like to work
with CogniPlus. The graphic is snappy, modern and
quite realistic; the instructions of the different trainings
[...] are clear and easy to understand and at the end of
each exercitation it is possible to immediately visualize
the results and the possible outcome of the performances in the different training sessions that have been
performed (thanks to the presentation of numeral tables and graphs). This usually is a very good feedback
for patients because it allows a better comprehension
of their results. Grounding on the problems that the
patient has, which have been ascertained previously
through a deep specialized test, we evaluate the exercise that should be done, the time (15-30-45 minutes)
and the number of weekly sessions.
We furthermore appreciate the theoretical and scientific aspects, on which the different contents of the
CogniPlus’ trainings have been planned, which are
broadly described in the user’s manual. It is possible to
measures the results of the rehabilitations trough the
WAF Test (Perception and Attention Function) of the
Vienna Test System. These are dosed, separately for
each sub-component of attention, before and after the
rehabilitation.“
minutes three times a week. At the end of the study
the program is incorporated into everyday activities at
the center. People are constantly coming forward to
use the computer and they also express interest in trying out the training program. Feedback from residents
is consistently positive; they enjoy the program – and
that includes those who never thought that they would
ever use the computer. It provides a welcome diversion
and an ideal supplement to the strength and balance
training.
ETH - Swiss Federal Institute of Technology
Zurich
We use the WAFG program in the Vienna Test System
to assess performance in divided attention tasks.
The automatic scoring of parameters including reaction time and number of omitted stimuli helps us to
work more efficiently, since we do not have to take
painstaking measurements ourselves.
Application: Cognitive training in centers for older people
Dr. Eling D. de Bruin
“In 2008 we were able to start using the CogniPlus
training system at the Alterszentrum am Etzel center
for the elderly in Feusisberg, Switzerland, as part of
a study being carried out for a Master’s dissertation.
Another advantage is that the training results can be
viewed after each session; this greatly increases users’ motivation. The difficulty level is adjusted automatically, which makes the training progressive and
efficient.”
The purpose of the study was to identify whether the
provision of cognitive training in addition to strength
and balance training has a positive impact on mobility.
There is growing recognition of the fact that, for elderly people in particular, maintaining physical stability
while walking requires cognitive resources and that it
is more difficult for these people to master dual tasks
(e.g. talking while walking) without deterioration of performance.
We decided at the outset to use CogniPlus because
this software can be used to train both divided and
selective attention. Other advantages are that the automatic adaptation to the user’s ability, the clear scenarios and the user-friendly keyboard make the system
particularly suitable for older people.
On account of the positive results in the final tests in
our study and the popularity of the training program
with the users, more and more homes were prepared
to take part in a further study conducted by ETH Zurich. This means that we have so far been able to equip
six other centers for the elderly with CogniPlus. Next
year we plan to run the study in seven additional centers for the elderly.
The computer training is carried out as part of the
study and involves each participant training for ten
COGNIPLUS
. 31
Service
Service
Best practice
CogniPlus in use
Rehabilitation department Grensás,
National Hospital of Iceland
Treatment and Rehabilitation Center for
Neurology and Orthopaedics (Bad Pirawarth)
Application: adult patients, treatment of post-acute
traumatic brain injury (TBI) and stroke
Application: Neuropsychological rehabilitation
Dr Claudia Ó. H.-Georgsdóttir
Clinical Neuropsychologist
“In late spring of 2010 the rehabilitation department
Grensás, at the National Hospital of Iceland (Landspítali háskólasjúkrahús) finally was able to purchase
CogniPlus with its subcomponents. This was made
possible through a generous grant by the Icelandic Lions Club Njörður.
Grensás neuropsychological rehabilitation is an in-,
out- and daypatient treatment facility for adult patients, mainly post-acute traumatic brain injury (TBI)
and stroke. Most of these patients suffer from some
sort of attentional dysfunction. CogniPlus is therefore
an exciting new venue for us in the rehabilitation of
these patients, especially given its theoretical basis
and emphasis on various subcomponents of attention.
We value the scientific background of CogniPlus, and
the in-depth explanations and descriptions in the user
manuals.
Several of our patients are now undergoing daily CogniPlus sessions at Grensás, about 30-45 minutes each
session, 5 days a week. Our experience so far is that
patients greatly enjoy these sessions as the material
is user friendly and interesting, training instructions
easy to understand, and the immediate presentation
of results immensely motivating. In addition, the tasks
within the various CogniPlus subcomponents are of intrinsic value to day-to-day functioning and as such an
important element to promote generalization of effects
to everyday life.
The outcome of rehabilitation is measured by the corresponding WAF (Perception and Attention Function)
subtests of the Vienna Test System which are administered, separately for each attention subcomponent.
This enables us to gather precise pre- and post data
on the improvement of attentional function due to the
actual CogniPlus rehabilitation process.”
Application: children and young people
Kerstin Heger
Clinical and health psychologist
“The psychology department at the neurological Treatment and Rehabilitation Center at Bad Pirawarth has
been using the neuropsychological training software
CogniPlus for more than three years. For patients with
impairments of cognitive functions as a result of stroke,
craniocerebral trauma, tumour surgery, Parkinson's
disease, MS, incipient or early-stage dementia and
other neurological diseases, CogniPlus provides some
effective training modules for improving the functioning
of attentional performance. This enables treatment to
be targeted at the patient's specific limitation.
At the Pirawarth clinic we have successfully used the
programs DIVID (divided attention), SELECT (selective
attention) and ALERT (alertness).
SELECT includes not only visual and acoustic variants
but also a crossmodal version which makes comparatively challenging demands on patients' abilities.
DIVID is particularly appealing in its design (airport
operations), and the various tasks are presented very
comprehensibly and realistically.
ALERT is designed in a varied and interesting way and
has a reality link to the attention function (the ride on
a motorcycle to train alertness); many patients find it
entertaining and motivating. The connection between
reaction speed and traffic situation is logical.
The instructions in all three program modules are easily understood without additional explanations and
the programs adapt well to the user's ability. The Response Panel is very user-friendly and also suitable for
patients with motor disabilities. The theory-led development of the training software, which has been specifically designed to improve particular facets of attention, and the (electronically) included and scientifically
sound manuals contribute to the very satisfactory use
of the system in our everyday work.
Given regular training (three to five units/week), significant improvements in attention are observed in some
patients.”
32 . COGNIPLUS
Neuro-oncology unit of the University Clinic
for Children’s and Young People’s Medicine
(Vienna)
Thomas Pletschko
Clinical and health psychologist, sociologist, University
Clinic for Children’s and Young People’s Medicine, AKH
Vienna
Dr. Ulrike Leiss
Clinical and health psychologist, University Clinic for
Children’s and Young People’s Medicine, AKH Vienna
Children & Young People’s Psychiatric Service
(Baselland)
“CogniPlus has been in successful use for more than
a year in the neuro-oncology unit at the University
Clinic for Children’s and Young People’s Medicine.
Angelika Berger
Dipl. Psych., neuropsychologist FSP/GNP, senior psychologist
The program has been found to represent a suitable
treatment option for a variety of indications. On the
one hand we use it for training neuropsychological
functions (where there are function deficits); on the
other it also proves very beneficial for children and
young people with a poor experience of self-efficacy
or low frustration tolerance.
“Since 2003 the Baselland Children & Young People’s Psychiatric Service in Switzerland has been
running therapy groups for children with ADS in the
age range 9 – 12, focusing on attention. A core tool
of this group therapy is computerised attention training – originally using the AIXTENT program and now
with the new version CogniPlus.
For the children themselves the programs are attractively designed and when used appropriately there is
very little need for additional motivating intervention.
Even the Divided Attention (DIVID) program, the
graphics of which have been designed with adults in
mind, is well received by children – not least because
it is set in an airport – and rouses their interest.
The group therapy, which is conducted by a team
of psychologists, is intensive; it consists of 20 sessions with the children and accompanying parents’
evenings. In the therapy sessions each child uses
the computer to work on two areas of attention.
By combining CogniPlus training with supporting
measures designed to ensure the transfer of training
effects to everyday life, optimum treatment success
can be achieved, as many case studies show.”
Application: Children with ADS
The children very much enjoy working with CogniPlus. The tasks are designed to arouse their interest
and the graphics are appealing. The use of the program is also easy for the children to master. Clinical
catamnesis indicates very satisfactory improvement
for a large proportion of the children as revealed
both in the re-testing of attentional performance and
in the assessments of parents and teachers.”
COGNIPLUS
. 33
Die CogniPlus-Trainingsverfahren
Service
System requirements
System requirements
As at: November 2012
Computer
ii PC with pentium or compatible CPU, min. 2.5 GHz
ii at least 512 MB RAM
ii D irectX 9.0 compatible 3D graphics card with at
least 128 MB RAM and a Nvidia (GeForce FX5200
or better) or ATI (Radeon 9500 or better) graphics
chip. The display driver must support Open-GL version 1.4 or higher.
ii USB headset or USB speakers. Please ask your
dealer or SCHUHFRIED GmbH about suitable devices.
ii DVD drive, hard drive, mouse, keyboard
ii USB ports for the license dongle and any additional hardware (if all the computer’s USB ports are in
use, a USB hub with external power supply will be
required).
ii serial port (if a Test System Interface is used)
ii network card for connecting the computer to a network (e.g. for setting up a test system network)
ii operating system: Windows XP/Vista/7 (x32 or x64)
It is important that no programs are installed on the
computer that could interfere with the presentation
of training (e.g. through high CPU usage or unwanted output on the screen).
Other quality products
from SCHUHFRIED
Monitor
ii CRT or TFT colour monitor with at least 15" visible
screen diagonal (19" for the SPACE training program).
ii For CRT monitors the refresh rate must be at least
75 Hz.
ii It is recommended that only synchronous TFT monitors are used; asynchronous screens may flicker
in a way that interferes with training. The test program PixPerAn can be used to check whether a
screen is synchronous or asynchronous.
Safety devices
If CogniPlus is used within the healthcare service,
use of the following devices is required:
ii m edical grade isolation
transformer in accordance with EN 6061
ii g alvanic medical network isolator in accordance with EN 60601 (if
the computer is connected to a data network)
Please ask your in-house
health and safety officer.
Worth knowing
Products of SCHUHFRIED GmbH
are developed and produced in accordance with EU Directive 93/42/
EEG. The CE mark confirms that our
products comply with technical safety
regulations, electro-magnetic compatibility guidelines (EN60601), biocompatibility guidelines (EN30993)
product-specific requirements and
quality management standards.
Printer (optional)
Laser or inkjet printer, black and white or color
34 . COGNIPLUS
Vienna Test System
Biofeedback 2000x-pert
Psychometric assessment
Multimedia system
The Vienna Test System (VTS) is known worldwide as the leading computerised
psychological assessment tool. The system
consists of powerful administration software,
the tests themselve and additional optional input
devices.
Biofeedback 2000x-pert is the innovative wireless biofeedback system from SCHUHFRIED. It
can be used for relaxation, rehabilitation and assessment. Buy just the modules that you need.
You can choose from more than 120 tests:
ii transmission of readings via radio technology
ii intelligence tests
ii ability tests
ii personality tests
ii attitude tests
ii clinical tests
(Bluetooth ®)
ii c ompact, lightweight radio modules that are worn
directly on the body
ii complete freedom of measurement during measurement
ii highly sensitive sensors with high stability against
artefacts
ii user-friendly, easy-to-use software
The key features of Biofeedback 2000 x-pert
These tests include not only computerised versions of
familiar paper-and-pencil tests but also auditory, multimedia and adaptive tests. They can be combined as
required in order to provide the best set of tests for your
particular purpose. We shall be happy to advise you!
Order now free of charge!
Order now free of charge!
E-mail: [email protected]
E-mail: [email protected]
Catalog Vienna Test System
Catalog Biofeedback 2000 x-pert
COGNIPLUS
. 35
Psychometric assessment
Vienna Test System
Cognitive training
CogniPlus
Biofeedback
Biofeedback 2000 x-pert
SCHUHFRIED GmbH
Hyrtlstrasse 45
2340 Moedling
Austria
Telephone +43 2236 42315
Fax +43 2236 46597
E-mail [email protected]
www.schuhfried.com